Each year plastic and reconstructive surgeons improve the lives of millions of patients with congenital malformations (such as cleft lip and cleft palate), disfiguring wounds, animal bites, and profound burn injuries, as well as those requiring reconstruction after surgery for malignancy or other chronic conditions. This column will not focus on these forms of plastic surgery, but rather on cosmetic surgery, or elective procedures to enhance those not encumbered by such disfiguring conditions.